Healthcare Provider Details

I. General information

NPI: 1093869083
Provider Name (Legal Business Name): ARROYO SECO MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 10/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S FAIR OAKS AVE SUITE 300
PASADENA CA
91105-2561
US

IV. Provider business mailing address

301 S FAIR OAKS AVE SUITE 300
PASADENA CA
91105-2561
US

V. Phone/Fax

Practice location:
  • Phone: 626-795-7556
  • Fax:
Mailing address:
  • Phone: 626-795-7556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW MULLER JR.
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 626-795-7556